Debris of carbon-fibers originated from a CFRP (pEEK) wrist-plate triggered a destruent synovitis in human
| Autor: | Francesco Federico, Antonio Merolli, Marco De Spirito, Lorenzo Rocchi, Luigi Mingarelli, Alessandro Morini, Francesco Fanfani |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty Materials science Surface Properties 0206 medical engineering Biomedical Engineering Biophysics Bioengineering Biocompatible Materials 02 engineering and technology Wrist Thumb Biomaterials Postoperative Complications Carbon Fiber Synovitis carbon fibers medicine Humans Process (anatomy) Aged Soft tissue Index finger Phalanx 021001 nanoscience & nanotechnology medicine.disease 020601 biomedical engineering Carbon Settore MED/33 - MALATTIE APPARATO LOCOMOTORE medicine.anatomical_structure Orthopedic surgery Microscopy Electron Scanning Female 0210 nano-technology Bone Plates Plastics Biomedical engineering |
| Popis: | Application of carbon-fiber-reinforced-polymer (CFRP) artifacts in humans has been promoted in Orthopedic and Trauma Surgery. Literature documents the biocompatibility of materials used, namely carbon fibers (CF) and poly-ether thermoplastics, like poly-ether-ether-ketone (PEEK). A properly designed and accurately implanted composite artifact should not expose its fibers during or after surgery: however this may happen. A white Caucasian woman came to our attention 11 months after surgery for a wrist fracture. She had a severe impairment, being unable to flex the thumb; index finger and distal phalanx of third finger. We retrieved a correctly positioned plate and documented an aggressive erosive flexor tendons synovitis with eroded stumps of flexor tendons. The plate and soft tissues were analyzed by Visible Light and Scanning Electron Microscopy. Histopathology showed granulomatous fibrogenic process with CF engulfed inside multinucleated giant cells. Fibers were unmasked and disrupted inside the holes where screws were tightened and corrugation of the polymer coating led to further unmasking. The mechanism of foreign-body reaction to CF has not been studied in depth yet, particularly at the ultrastructural level and in Humans. This case documents a damage occurred in a clinical application and which was theoretically possible. Our opinion is that a proper way to promote the use of CRFP in the Clinic in the short term is to direct Research towards finding a better way to prevent CF debris to be exposed and released. In the longer term, the biological response to CF deserves a deeper understanding. |
| Databáze: | OpenAIRE |
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